Comprehensive Sex Ed Empowers Youth

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OUR VOICES & EXPERIENCES MATTER:
THE NEED FOR COMPREHENSIVE SEX EDUCATION
AMONG YOUNG PEOPLE OF COLOR IN THE SOUTH
2015

TABLE OF CONTENTS
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TABLE OF CONTENTS
Acknowledgements & Organization Information……….…………………………………………………………………………….03
Introduction: A Reproductive Justice Approach……………………………………………………………………………………….05
The Value of Comprehensive Sex Education……………………………………………………….……………………………………08
Comprehensive Sex Education in Tennessee Law………………………………...…………………………………………………..12
Memphis Voices: Results from the Focus Groups…..……………………….………………………………………………………..14
Looking Ahead: SisterReach’s Recommendations……………..……………………………………………………………………..23
Conclusion: It’s Time for Change………..…………………………………………………………………………………………………...24
Citations………………………………………………….………………………………………………………………………………………….....25

ACKNOWLEDGMENTS & ORGANIZATION INFORMATION
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Special thanks to Karla Torres and Katrina Anderson from the Center for Reproductive Rights for their
research and content support. Special thanks to Jenny Dodson Mistry and Ami Cholia from the National
Institute for Reproductive Health for their content and graphics support. Your partnership is appreciated
and valued in making this report an important piece of our work as we continue to advocate for families in
Memphis and throughout the state of Tennessee.
SisterReach
1750 Madison Avenue, Suite 600
Memphis, Tennessee 38104
Tel (901) 222.4425
Fax (901) 222.4441
http://sisterreach.org/
We believe that women and girls of color, poor and rural women deserve the access and opportunities of
every other Tennessean and American. As the women we serve, we recognize that without education about
our bodies and sexuality, our ability to be self-determining and control the trajectory of our lives is impeded
– further unraveling the opportunity to sustain our lives and our communities.
Our overarching goal is to empower ourselves and other women and girls as together we work as change
agents for our communities. In that same spirit, our children’s access to all of the information available
about their bodies and sexuality is paramount to ensuring the health and well-being of current and future
generations.
This report is part of that strategy - to lift the voices and center the discussion of those most marginalized as
an attempt to ensure our human rights and save our own lives.
Cherisse A. Scott
Founder & CEO
SisterReach

ACKNOWLEDGMENTS & ORGANIZATION INFORMATION
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MISSION STATEMENT
SisterReach is a 501c3 grassroots organization focused on empowering and mobilizing women and girls of
color, poor and rural women and their families around their reproductive and sexual health to make
informed decisions about themselves, therefore to become advocates for themselves. Our goal is to support
women and girls to lead healthy lives, have healthy families and live in healthy and sustainable communities
by offering fundamental education about their sexual and reproductive health. We do this with a three-
pronged strategy of education, policy and advocacy through the framework of Reproductive Justice.
ORGANIZATIONAL PLEDGE
SisterReach is committed to empowering women and girls from all walks of life, ethnicities, genders and
faith beliefs.
We believe that a woman is most empowered when she has access to all information regarding her health
and well-being.
We are committed to and work from a framework of Reproductive Justice.
We support a woman’s right to lead a healthy life, raise a healthy family and live in a healthy community.
We do not discriminate against women in need based on her socio-economic standing, sexual orientation,
age, religion, sexual orientation or race.
SisterReach employs the biblical principal expressed in Hosea 4:6 KJV, “My people are destroyed by lack of
knowledge…” Our support of education is founded in this principal and connected to our commitment to
optimum reproductive and sexual health.
Learn more about our work at: www.sisterreach.org

INTRODUCTION: A REPRODUCTIVE JUSTICE APPROACH
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Comprehensive reproductive and sexual health
education (CSE) provides young people with
critical information on how to protect their
health and the skills to do so. Access to scientific,
accurate, and unbiased information on sexual
health and sexuality, including information on
contraception, can delay a young person’s first
sexual experience, increase use of contraception,
and lead to fewer sexual partners.3 Additionally, CSE has been recognized as a powerful mechanism for
reducing maternal mortality4, infant mortality5, abortion rates6, adolescent pregnancies7, and HIV/AIDS
prevalence.8 Yet abstinence-only education, now renamed sexual risk avoidance education, is the curriculum
chosen by lawmakers in Tennessee, and in Memphis, even that may be out of reach.
Shelby County’s rates of chlamydia and HIV
diagnoses are more than double the nation’s.9,10
Rates of gonorrhea are more than triple.1112 In
2012, African Americans accounted for more than
90% of reported case of both AIDS13 and chlamydia
in Shelby County.14 According to the 2013 Youth
Risk Behavior Surveillance System (YRBSS) study,
more than half of Memphis’s high school students
have ever had sex, and nearly a quarter have had
sex with four or more persons.15 In Shelby County,
the rate of teen pregnancy is approximately 30%
higher than that of the state,16,17 and nearly 80% of
teen mothers live in households with incomes
below $10,000/year.18 The data makes it plain –
Tennessee’s abstinence-only education has not
prevented Memphis’s youth from engaging in
sexual activity; it has only made them less prepared to engage in such activity safely and responsibly, and
this lack of information has the short and longer term potential to harm our youth of color and poor youth
most.
1 Per 100,000, 2012
2 Per 100,000, 2012
3 Per 100,000, 2012
4 Per 1,000; 2010 data
Shelby Co. USA
HIV1 37.1 15.8
Gonorrhea2 395.1 107.5
Chlamydia3 1067.6 465.7
Teen
pregnancy4
71.21 57.42
“We need to involve sex-ed in all curriculums along with math, language arts, etc. if we
want students to be productive and part of the work force. It’s something that we have to
push for a better Tennessee. If we see them as our own kids, we’ll do something about it.”
- Memphis Teacher
Population in Memphis, TN, by Race
U.S. Census 2013

INTRODUCTION: A REPRODUCTIVE JUSTICE APPROACH
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Statistics and data are only one part of the
Memphis story; this report puts these numbers in
context by presenting the views of Memphians
who study, parent, teach, and live in the
community, using a Reproductive Justice lens. The
framework of Reproductive Justice moves beyond
the epistemological boundaries of upper- and
middle-class conceptions of reproductive health,
education, and access for women and girls of
color, poor and rural women to center the issues
that are germane to them. These include access to
comprehensive reproductive and sexual health
education for all young people that considers
their sexuality, access to contraception,
environmental determinants, and socioeconomic
status. Reproductive Justice is not only concerned
with access to reproductive health information and choices, but also the intersectionalities of race, class,
age, gender preference, religion and socio-economic status ensuring that marginalized women and girls and
their families are able to make such choices with dignity, provide for themselves, and reach their full human
and social potential.
Reproductive Justice roots the discussion on CSE around those who are and will be most affected by the
limited and biased sex education model currently in place in Tennessee. It elevates the voices of
marginalized millennials, parents, and teachers, who offer points of view from their lived experiences that
are markedly different from the narratives of those who control local and state policy. Through their stories,
we highlight barriers these communities face as a result of a lack of knowledge, access, and political power –
circumstances that ultimately contribute to unplanned pregnancy, sexually transmitted infections, and
economic disparities that stretch far beyond the high school years.
Reproductive Justice Is Every Woman and Girl’s Right To:
 Decide if and when she will have a baby and the conditions under which she will give birth
 Decide if she will not have a baby and her options for preventing or ending a pregnancy
 Parent the children she already has with the necessary social supports in safe environments and
healthy communities, and without fear of violence from individuals or the government
Income Levels in Memphis, TN
U.S. Census 2013

THE VALUE OF COMPREHENSIVE SEX EDUCATION
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WHAT IS COMPREHENSIVE SEX EDUCATION?
According to the Sexuality Information and Education Council of the United States (SIECUS), Comprehensive
sex education includes age-appropriate, medically accurate information on a broad set of topics related to
sexuality including human development, relationships, decision making, abstinence, contraception, and
disease prevention. They provide students with opportunities for developing skills as well as learning. These
programs:
 provide young people with the tools to make informed decisions and build healthy relationships;
 stress the value of abstinence while also preparing young people for when they become sexually
active;
 provide medically accurate information about the health benefits and side effects of all
contraceptives, including condoms, as a means to prevent pregnancy and reduce the risk of
contracting STIs, including HIV/AIDS;
 encourage family communication about sexuality between parent and child;
 teach young people the skills to make responsible decisions about sexuality, including how to avoid
unwanted verbal, physical, and sexual advances; and
 teach young people how alcohol and drug use can effect responsible decision making19
THE CASE FOR SEX EDUCATION
Science
Knowledge empowers young people to make
healthy decisions. Strong scientific evidence links
CSE to declines in teen pregnancy, delays in first
intercourse, and an increased likelihood of using
contraception during intercourse.20 One peer-
reviewed study found that teens who had received
CSE were half as likely to have experienced
pregnancy as their peers who had not.21 Another
study demonstrated that CSE was significantly
associated with a decrease in the likelihood that
female teens would report their first intercourse as
unwanted and that either sex would have an age-
discrepant partner.22 When CSE covers topics like
healthy relationships, healthy communication, the impact of risky behavior practices and understanding
differences in sexual orientation and gender, the benefits can be even more wide-ranging; addressing these
issues can reduce intimate partner violence,23 sexual assault,24 hate crimes and bullying.25 It is important to
Citation: Abstinence-Only and Comprehensive Sex Education and the
Initiation of Sexual Activity and Teen Pregnancy Kohler, Pamela K. et al.
Journal of Adolescent Health, Volume 42, Issue 4 , 344 - 351
“These data suggest that formal comprehensive sex
education programs reduce the risk for teen
pregnancy without increasing the likelihood that
adolescents will engage in sexual activity, and
confirm results from randomized controlled trials
that abstinence-only programs have a minimal effect
on sexual risk behavior.”
- Journal of Adolescent Health

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note that there is little data to show that abstinence-only education produces similar outcomes.26,27 A
federally-funded evaluation of these programs found that they do not even achieve their stated purpose: to
increase rates of sexual abstinence.28
The Human Rights Framework
Sexual and reproductive rights are fundamental rights. They are essential to the realization of other basic
human rights, including the right to life, health, equality, and non-discrimination. These rights find
expression in international human rights treaties to which the United States is party, including the
International Covenant on Civil and Political Rights29 and the International Convention on the Elimination of
All Forms of Racial Discrimination.30 The rights enshrined in these treaties are based in established law, as
well as international consensus agreements that the United States has supported, such as the International
Conference on Population and Development.31 The sexual and reproductive rights framework includes the
right to sexual health, defined by the World Health Organization as “a state of physical, emotional, mental,
and social well-being in relation to sexuality” that “requires a positive and respectful approach to sexuality
and sexual relationships.”32 Individuals and couples possess the right to attain the highest standard of sexual
and reproductive health, and this framework recognizes that the underlying determinants of health must be
addressed to achieve this vision. Access to a comprehensive standard of education is widely recognized as
one of the tools available to do this work.33
International human rights bodies have held the United States government to account for failing to reduce
disparities in sexual and reproductive health among women of color. In 2008, the Committee on the
Elimination of Racial Discrimination expressed concern about the high racial disparities in unintended
pregnancy, STIs, and abortion for women of color.34 The Committee urged the Unites States to “provid[e]
adequate sexual education aimed” at preventing unintended pregnancies and STIs.35
The Committee Recommends That The [United States Of America] Continue Its Efforts To
Address Persistent Racial Disparities In Sexual And Reproductive Health, In Particular By:
 improving access to maternal health care, family planning, pre- and post- natal care and
emergency obstetric services, inter alia through the reduction of eligibility barriers for Medicaid
coverage;
 facilitating access to adequate contraceptive and family planning methods; and
 providing adequate sexual education aimed at the prevention of unintended pregnancies and
sexually-transmitted infections.

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Addressing Gender Disparities
The benefits of CSE contribute towards
building a world where women [and girls]
are able to live a life free of violence and
gender discrimination.36 By educating young
people on their right to sexual health and
sexuality and providing information that
works against gender stereotypes, young
people learn tools that can help them be full
and equal members of society. Offering
education to young people lays the
groundwork necessary to ensure healthier
decision-making and improved sexual health
outcomes as they enter adulthood.
Incorporating sexual orientation and gender identity into CSE can reduce stigma and discrimination among
(Lesbian, Gay, Bi-sexual, Transgender, Queer, Intersex, and Androgynous) LGBTQIA youth. Abstinence-only
education uses a heteronormative framework and reinforces heterosexual marriage as the only suitable
context for sexual relationships, stigmatizing youth that identify as LGBTQIA.37 In a 2011 School Climate in
Tennessee study, 90% of LGBTQIA students surveyed regularly heard negative remarksv from students
about others’ gender expression, 30% heard similar negative remarks from school staff, 23% heard
homophobic commentsvi from staff, and only 9% encountered positive representations of LGBTQIA people
in their curriculum.38 Applying a Reproductive Justice lens to those scenarios means that young people,
enduring these negative scenarios, are victims of violence and that is a human rights violation. Further, by
excluding LGBTQIA-focused education and awareness materials as part of any sex education curriculum,
means that lawmakers and school officials are perpetuators of that victimization.
Research shows that stigmatizing certain sexual behaviors and identities can lead to risky behavior. For
example, a study of LGBTQIA students in Massachusetts found that those adolescents who received
LGBTQIA-sensitive HIV education had a lower risk of engaging in risky sexual behavior than students who
did not.39 A curriculum that is not inclusive and accepting of LGBTQIA students’ lived experiences, such as
Tennessee’s Family Life Curriculum, denies young people the information they need to protect their health,
form safe and healthy relationships, and live free from stigma and fear. What’s more, in a culture where
bullying is already so much the norm among youth, it is vital that we use all of the tools at our disposal to
ensure that all of our youth are safe and protected.
v Defined as “general unfavorable statements or comments”
vi Defined as “specific unfavorable statements against or about gay people”

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The case for CSE is strong. Scientific
research, the human rights framework,
and the realities of life in Memphis all
point to the need for youth to have the
tools and support they need to make
informed decisions about their sexual and
reproductive health. Without this access,
young people are left vulnerable to
unplanned pregnancy, the transmission of
sexually transmitted infections, including
HIV, lack of education, and lack of
employment to sustain themselves and
their families. Yet in 2012, Tennessee, and
subsequently Shelby County, took the
opposite tack.

COMPREHENSIVE SEX EDUCATION IN TENNESSEE
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THE LAW IN TENNESSEE
SB 3310, better known as the “Gateway Sexual Activity” or
“No Hand Holding” law, was signed by Governor Bill Haslam
in 2012.40 The law states that in every county where teen
pregnancy exceeds a certain rate, of which Shelby County is
one, each local education agency (LEA)41 “within the county
shall locally devise, adopt, and implement a program of
family life education in conformance with the curriculum
guidelines established by state law.”42 Qualified healthcare
professionals or social workers can help teach family life,
but any “individual or organization that endorses student
non-abstinence as an appropriate or acceptable behavior, or…promotes ‘gateway sexual activity’ is not
permitted.43 44
SB 3310 requires emphasis on elements of the curriculum that discourage sexual activity outside of
marriage and stress the social, emotional, physical, and psychological “effects” of “non-marital sexual
activity” and “emphatically promote only sexual risk avoidance through abstinence, regardless of a student’s
current or prior sexual experience.”45
The law also explicitly allows parents or guardians to opt their children out of family life education.46
Further, the law allows a parent who believes that the law has not been fully complied with to file a
complaint with the director of schools47 and, “if a student receives instruction by an instructor or
organization that promotes gateway sexual activity or demonstrates sexual activity…then the parent or legal
guardian shall have a cause of action against that instructor or organization for actual damages.”48
While The Information Provided Must Be Factual And Medically Accurate, And Should Cover
Unhealthy And Healthy Relations, No Curriculum May:
 Promote, implicitly or explicitly, any gateway sexual activity or health message that encourages
students to experiment with non-coital sexual activity;
 Provide or distribute materials on school grounds that condone, encourage, or promote student sexual
activity among unmarried students;
 Display or conduct demonstrations with devices specially manufactured for sexual stimulation; or
 Distribute contraception on school property; provided, however, that medically accurate information
about contraception and condoms may be provided so long as it is presented in a manner consistent
with the preceding provisions of this part and clearly informs students that while such methods may
reduce the risk of acquiring sexually transmitted diseases or becoming pregnant, only abstinence
removes all risk.49
“’Gateway sexual activity’ means sexual
contact…that could precipitate
engagement in a non-abstinent behavior. A
person promotes a gateway sexual activity
by encouraging, advocating, urging or
condoning gateway sexual activities.”
- SB 3310

COMPREHENSIVE SEX EDUCATION IN TENNESSEE
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Memphis City Schools Responds to Gateway Law with Opt-In Policy
In response to SB 3310’s passage, Memphis City Schools (MCS), as the LEA of the time,vii was charged with
developing a family life curriculum within these confines. Anxious about the provisions of SB 3310 that
allows parents to sue instructors or organizations for damages, the new Memphis policy required that
parents opt in to the curriculum in order to permit their students to participate. Notoriously unsuccessful,50
such an opt-in provision means that many children will lose out on their only opportunity to access sex
education in schools – however biased and narrow – if they are unable to turn in a signed permission slip.
In response to the passage of this law and understanding the importance of CSE as a tool for improving
outcomes in Memphis and throughout the state of Tennessee, SisterReach set out to learn from the
community about what they were experiencing on the ground. This report is the first in the state to
reflect the views of people of color specifically on CSE, featuring the voices of African-Americans in
Memphis, who represent the majority population in the city and who face the highest rates of health
disparities in Tennessee. Their voices lay bare the need for CSE in this city, and challenge the notions of
politicians in Nashville who seem to believe that they can regulate sexuality and rectify the many challenges
this community faces by banning discussion of “gateway sexual activity.”51
vii In 2013, Memphis City Schools (MCS) and Shelby County Schools merged in the largest school district
consolidation in history. Shelby County Schools continues the policy initially voted on by MCS.

MEMPHIS VOICES: RESULTS FROM THE FOCUS GROUPS
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METHODOLOGY
This report includes data from three focus groups, with teens aged 11 to 16 (5th grade to 11th), with parents
who live in marginalized communities, and with teachers working at schools situated in marginalized
communities or serving a significant portion of marginalized youth. Participants were recruited through the
SisterReach newsletter and Facebook account, community representatives, and SisterReach’s ally
organizations and partners. Teens were also recruited from the SisterReach Youth Ambassadors program.
Respondents were eligible to participate if they lived, worked, or went to school in zip codes identified as
high-risk for HIV by the Shelby County Health Department’s 2012 HIV disease and STD Annual Surveillance
Summary.52 Potential subjects contacted SisterReach on either a dedicated phone line or by email, and were
screened by project staff for the criteria as identified above. Teen participation required consent from a
parent or guardian. The only persons in the room during the focus groups were the facilitator, the note-
takers, and the participants. A funding program officer was present for the teacher focus group only.
SisterReach believes it is important to hear directly from community members about what they are
experiencing and what they say they need. To our knowledge, this is the first time that anyone in Tennessee
has specifically asked African Americans for their views on CSE and reported on it. It is important to note,
however, that this is a small sample and cannot be evaluated for statistical significance. Our hope is that
further research will be done to evaluate the impact of the laws in Shelby County and in Tennessee, and that
any future policies will include the input of the communities they impact.
Description of Participants
A total of 55 individuals contacted SisterReach with interest in participating in the focus groups. Of these, 25
individuals were eligible based on screening criteria; the others were ineligible, typically because they did
not meet either the zip code or ethnicity qualification. In the case of the teacher focus group, some
participants were turned away because the group was over capacity. Of the 25 participants, 24 were African
American and one, a teacher, was Caucasian and worked in a high-risk zip code. Most of the participants
were female, and the majority either lived or worked in a high-risk zip code.
DEMOGRAPHICS OF FOCUS GROUP PARTICIPANTS
Race Gender Zip Code
N % N % N %
African-American 24 97% Female 23 92% High-Risk Zip Code 19 76%
Caucasian American 1 3% Male 2 8% Non-High-Risk Zip Code 6 24%
TOTAL 25 100% TOTAL 25 100% TOTAL 25 100%

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ZIP CODE LOCATION OF PARTICIPANTS53
Teens
The purpose of seeking out teens to speak on their own behalf is two-fold. The first is to honor the intention
of Reproductive Justice by creating space for the most marginalized voices to be heard. Adults, whether a
parent, guardian, or policymaker, have the ultimate authority to make decisions for and give or take rights
from young people. No matter how well-intentioned, this can be problematic and even damaging to their
daily lives and development if these authorities do not create a space for the voices of youth. These
authorities run the risk of making decisions that serve only their own interests and comfort level, leaving
the needs of youth in an ever-changing society unmet. The second purpose is to honor the lived experiences
of African American youth, who face the highest rates of teen pregnancy, STIs including HIV, infant mortality,
sexual violence, and poverty among their peers.54,55
Parents
Parents and guardians are generally the most important people in their adolescents’ lives, and often they are
the adults who know them best. They are powerful advocates for their children. As such, it is essential to
hear their opinions on what they want and need for their children. At the same time, many politicians who
oppose CSE claim that children should be receiving this information in the home, from parents or guardians.
But without accurate information about their own reproductive health, parents may impart incorrect and
even potentially harmful information. For example, among African American women, vaginal douching is a
practice that has been passed down among the generations.56 However, studies have proven that douching
can lead to bacterial vaginitis (yeast infection), vaginal dryness or even low birth rates in babies. Though a
38109
38111
38112
38114
38115
38116
38117
38118
38126
38127
38134
38135
38107
represents non
high risk identified
zip codes
76%
24%

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well-intentioned directive to ensure “good hygiene” from parents, douching is no longer supported by the
medical community as necessary unless under the guidance of a physician; this information has not
penetrated in much of the community that engages in this practice. While some parents are very informed
about reproductive health, many lack access to evidence-based information while others are fearful of
having the “sex talk” altogether. In these cases, it is critical to the reproductive well-being of adolescents to
have a viable source for information under the guidance of trained professionals, such as at school. This
focus group elucidates what parents want for their children and highlights the gaps in what they feel they
can provide in the home.
Teachers
In her article, “redefining the Role of the Teacher: It’s a Multifaceted Profession,” Judith Taack Lanier states
that
“[the teacher’s] job is to counsel students as they grow and mature – helping them integrate their
social, emotional, and intellectual growth – so the union of these sometimes separate dimensions
yields the abilities to seek, understand, and use knowledge; to make better decisions in their
personal lives; and to value contributing to society.”57
Seeking the input of teachers on sex education is vital. Teachers provide a window into teens’ behaviors,
experiences, and needs while in their care – away from their parent or guardian. Teachers are the other
adults that youth have significant exposure to beyond their parents or guardians, and therefore play a vital
role in their development. Many times, they act as a mentor and counselor to youth whether that is their
intention or not. Yet they also intimately understand the reality of life in the Shelby County School System,
and the limits on their own resources and that of their schools. Thus, their analysis and input provides a
nuanced understanding of what is needed and what is possible in Memphis.
THE REALITY: LACK OF INFORMATION HARMS TEENS AND THEIR FAMILIES
Absence of Information Leads to Misconceptions, Unprotected Sex
Denying adolescents’ access to CSE in school fails to prepare them for the reality of sex, adulthood, and
parenthood. When asked what type of sex education they had received in school, most of the teens (80%)
said they learned about abstinence and sexually transmitted infections. Ten percent had discussed some
combinations of drugs and sex in the classroom setting. None of the teens received education that included
discussion of same-sex relationships, contraception negotiation
practices, or sexual assault.
Almost all of the youth surveyed (90%) said that they did not believe
they were given all of the information they needed in order to be fully
educated about their bodies or sexual choices. Parents and teachers
concurred that young people were not as informed about sex and
sexuality as they needed to be and that school played a critical role in
reinforcing what they hoped was being discussed with teens in the
home. One common theme between parents and teachers was that
“[Young people] don’t have the
proper knowledge to make that
decision and everything that
comes with it.”
– Memphis Parent

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youth lack the information they need to make knowledgeable decisions about their bodies and sexual
health.
This was backed up by the misinformation teens shared in their focus groups, and it is clear that this lack of
information could have dire consequences for teens’ reproductive health. Many of the female teen
participants in the study held a deep mistrust of the medical community and believed that birth control
options were potentially harmful to them.
When asked about access to condoms, the adolescents did believe that using condoms was safe and said
they did or would use them, but also shared that they often faced barriers in obtaining them. For example,
some incorrectly thought there was an age limit for purchasing condoms from the store. Others expressed
that staff at local pharmacies would interrogate them about
why they needed or wanted condoms, another significant
barrier for young people. Though forty percent of parents
said they would provide condoms to their teen upon request
and thirty percent had a specified location in their home
where their child could access condoms, students explained
that asking parents or guardians for condoms could mean
being embarrassed or disciplined. The existence of these
barriers at home meant that teens were likely to forego that
option and either seek out condoms elsewhere or not use
them at all. More than 80% of the teens said that if they
could not access a condom, they would most likely go ahead and have unprotected sex.
Parents Lack Resources, Confidence to Teach Sex Education
Lawmakers who support an abstinence-only sexual health curriculum imply that youth learn other
important information on topics like contraception negotiation, LGBTQIA-specific sexual health education,
menstruation, and masturbation education at home. Unfortunately, this does not ensure that even parents
would know or have access to comprehensive reproductive and sexual health education. It also does not
take into account the high rates of STIs and unplanned pregnancies among adults in many of these same
communities. Further, this presumptuous stance fails to take into account the fact that many parents are
uncomfortable talking about sex with their children, even if they do have all the answers and believe their
children need CSE. Only 30% of parents indicated that they were comfortable talking about these topics
with their children. More troubling, parents and teachers alike made it clear that even those parents who are
comfortable with these conversations may not have access to age-appropriate and medically accurate
information to share with their child. The study revealed that more than 70% of parents did not feel well-
informed about their own reproductive health and relied primarily on personal experience as their primary
source of knowledge on the subject.
“I think I have my moments, ‘Am I saying the right thing?’ If I don’t really feel safe telling them this, I go do
research. I’m constantly still learning.” – Memphis Parent
“Well, the pill is off a little bit. And the
shot, I haven’t had the [Depo Provera]
shot, but I had the pills. And they told me
that the shot will make my bones weak.
Like if you fall a little bit, you can break
your arms or your wrist. It will make
your bones weak.”
– Memphis Teen

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“There’s so many questions out there that parents can’t answer. Sex ed is a safe place for [teens] to get true real
knowledge about condoms, birth control, abstinence, be informed.” – Memphis Teacher
“Yes, [comprehensive reproductive and sexual health education] is needed, and maybe a class for parents, too, if
they’re not knowledgeable on how to go about teaching their child.” – Memphis Parent
When asked if they thought their teens would come to them with questions about sex, none of the parents
were able to give a definite answer. All of them hoped that their children would.
“You have to be comfortable. A lot of parents are uncomfortable about their own sexuality.” – Memphis Parent
Teens Face Curiosity and Pressure, Without Support
Despite claims from supporters of abstinence-only education that this type of curriculum will mitigate the
“sexualization of youth”, both sexually active and non-sexually active youth participants expressed that they
felt constant pressure from their peers to either engage in or continue having sex. One male participant in
the study recounted how his friends had been pressuring him to ask a young woman for sex. He was vocal
about the fact that he was a virgin, but he felt it was expected that he should not have been.
Teachers backed up these assertions, noting that abstinence did not seem to be valued among the majority
of the students they taught.
In response to a question about whether those students who were virgins felt supported or not, one student
responded: "Yeah, because I don’t want to disappoint my momma and no, because your friends talk about [sex]
and you wanna do it so bad.” – Memphis Teen
Teens in the group talked about their curiosity about sex, and teachers reported that in the absence of other
resources, teens were sharing often-inaccurate information amongst themselves.
“They’re so hungry for information, but they don’t want to let friends know they don’t know, they want to seem
cool, don’t want to seem questioning.” – Memphis Teacher
“Guys talk about trying to make their own condoms – Saran Wrap.” – Memphis Teen
Parents Unaware of Sex Ed Policy
Many of the parents in the focus group were unaware that
Tennessee’s sex education curriculum had been updated
and now specifically mandated abstinence-only education.
Other parents said that they had little to no knowledge
about what their teen was being taught in the first place.
None of the parents had been asked for their opinions
on what they believed their teens need to be taught.
More than half of the participants said that they had not received any communication from their child’s
school explaining the new school policy regarding sex education or any information allowing them to opt
their child in to the curriculum that would be taught. Those parents who did report receiving the permission
“…As an administrator, I didn’t hear about
it in school. I heard from the news.”
– Memphis Parent who works
for the school system

18
slip felt that it was not clear what type of sex
education youth would or would not receive.
This reflects a common criticism of this new
policy, that requiring parents to opt in to
education throws up even greater barriers to
students accessing the information they need. It
is unclear from this discussion whether or not
permission slips were sent home and parents
did not receive them, or if the permission slips
were never sent home at all.
Teens Feel Disempowered
None of the teens were aware that the sex
education law had changed, and none of them had ever been asked by authorities what they felt they
needed in a sex education class. The students expressed feeling disempowered by their inability to
express their sex education needs to trusted adults or decision makers. Teachers supported this assertion.
“[Adults] talk too long and not let you get your point out and they don’t understand.” – Memphis Teen
“All the reality is – that it’s not going to change unless we make a voice for it. And the people who are there, who
really need this curriculum, are not going to have a voice.” – Memphis Teacher
Teachers Lack Guidance
All of the teachers reported that they received no information form the administration about the policy
changes on either the state level or in Shelby County. Some teachers learned about the new policies for the
first time during the focus group discussion, over a year after the Shelby County policy was put in place.
Most of the teachers were unfamiliar with the requirement that opt-in forms be sent home to parents.
Because so many teachers identify a need for CSE, some of those in the group shared that they had taken the
initiative to bring in outside groups such as SisterReach to offer CSE to students. The lack of information
teachers received about the policies could prove particularly detrimental, if not devastating, for some of
these agencies, as teachers were also unfamiliar with the stipulation that such agencies could be fined up to
$500 per child for teaching anything outside of the policy’s guidelines.
After learning about the policies during the session, teachers expressed fear that students would not get all
of the information needed under the new curriculum. They felt at a loss for ways to support students
seeking advice or information about sex moving forward.
“I think it’s wrong. We know our people. Those up there in Nashville – they don’t know our people. They don’t
know what they need.” – Memphis Teacher
“[Take] a closer look and come to be more involved in our schools and actually see what the communities and
our families are going through. [Policymakers] truly need to be educated.” – Memphis Teacher

19
Given the reality of the situation, it should come as no
surprise that the evidence-based resources and education
that students of color, their parents, and their teachers are
asking for are nowhere to be found in the current
curriculum.
Students need comprehensive reproductive and sexual
health sex education to be taught in schools, period
Parents, teachers, and the students themselves all agree that
youth in Memphis are desperately in need of more education
and resources. In the absence of CSE in schools, some students do learn from their parents, but all agree that
this is not sufficient and needs to be reinforced. Some students are not getting any information at home, and
many are learning from their peers instead.
“[Comprehensive sex education] is much needed in schools, because I know parents teach it at home, but they
need reinforcements, because there’s so many unwanted pregnancies and young children having sex.” –
Memphis Parent
“I haven’t really talked to anybody who makes me feel like I can open up. I look around for people who can
understand me.” – Memphis Teen
Given this climate, there was agreement
amongst all three groups that Memphis
schools need CSE. Participants
recommended that sex education be
mandated to start at an early age, and that it
be given the same high priority as more
traditional academic subjects.
“We do need to teach sex ed, teach the whole
child.” – Memphis Teacher
“I think it needs to be taught from every
angle, there are many parts to sex education,
they need to break it down, and I also think
they need to start young, because at 11
they’re making decisions.” – Memphis Parent
Another parent echoed this opinion: “[Comprehensive sex education] is a necessity, it’s no longer an either/or
thing. Sex education, it wraps up a lot of things that we are physically. It should be made a part of the
curriculum, not just offered. It should carry its own weight.” – Memphis Parent
“Parents need to be involved, like [we are
with] math, science. [Sex education] has
to be all-inclusive. It needs to be
mandated, and [parents need to know]
when it’s going to start.”
– Memphis Parent

20
When asked what she believed was needed in the community, another parent said: “Comprehensive sex
education curriculum, so that [youth] may be fully aware and educated, so they can make the best possible
decision for their life.” – Memphis Parent
Not only is a comprehensive dialogue between youth and their parent/guardian needed at home, but
resources at school are essential to filling some of the gaps teens face and must overcome for the sake of
their health and well-being.
Parents Can’t Do It All
While parental involvement is crucial and all parents affirmed that they want to teach their children, all
groups also acknowledged that parents can’t do everything, even if they do have all the information they
need. Teens in the study seek confidential adults to talk to outside of their family circle, and not all parents
are able to offer the kind of open and nonjudgmental education youth need. Teens also called for a sexual
health clinic in all schools, particularly to meet the needs of students who are already sexually active or
pregnant.
“I feel best talking to a confidential person [like a guidance counselor] – not parents, cause they to get in-depth
of it. They want to ask a bunch of questions.” – Memphis Teen
“I think we should [have a clinic at school], we have four people walking around pregnant. Just cause they made
a bad decision, they aren’t a bad person…Why not help them get what they need in school?” – Memphis Teen
The Benefits of CSE Are Long-Lasting
Teachers and parents repeatedly focused on the fact that CSE will not only allow students to protect
themselves now, but will also benefit them for the future. Teens themselves, while visibly struggling with the
decision of whether or not to have sex, demonstrated a clear understanding of the connection between
making good decisions about their sexual health now and securing a better future long-term.
“It’s a disservice to our students to not be taught sex ed. People in higher-up positions, board members, they
need to talk a closer look at what is going on in the schools, come and be more involved in our schools, actually
see what the communities and the families are going through.’ – Memphis Teacher
“I don’t wanna get pregnant, I wanna go to college.” – Memphis Teen
In low-income communities, where parents and teachers are overstretched and under-resourced, this
aspect of CSE is important to recognize. Teaching students to understand their sexuality and to take and
maintain control of their reproductive health can positively impact on the individual, and that ultimately
benefits the community in which that person lives. Memphians in the focus group also talked about the
importance of CSE as a way for people in their community to escape the cycle of poverty, and to better the
city and the state.
“If you look at poverty, the reasons so many of our parents are in it is because they have [large families]… [CSE
is] needed not just for diseases but for your life and your family’s life.” – Memphis Teacher

21
“If the system stays, the same people keep making money. If we keep having people in poverty, we keep having
people that can’t contribute.” – Memphis Teacher
Low-income communities across Tennessee, where employment, healthcare, community based funding and
capacity are needed the most, are under-resourced. In communities of color and poor communities,
legislators’ failure to identify systemic factors contributing to these circumstances and failure to seek
guidance from those most affected when crafting legislation perpetuates harmful outcomes that can take
decades to repair for these communities. Further, legislators’ commitment to crafting legislation that does
not include a critical analysis of its impact on these communities leads to a deeper distrust of political
leaders among voters of color, poor voters and their children.
“To educate [young people] on abstinence-only is leaving them behind…my whole thing is, at [the state] level,
do decision makers really care?” – Memphis Parent

LOOKING AHEAD: SISTERREACH’S RECOMMENDATIONS
22
BASED ON OUR RESEARCH, SISTERREACH MAKES THE FOLLOWING RECOMMENDATIONS.
Policy
 Tennessee must change its abstinence-only sexual risk avoidance curriculum and adopt a CSE
model that promotes sexual and reproductive education for all young people despite gender
preference, sexuality or sexual experience level.
 Parent-focused CSE is vital to support the reduction of teen pregnancy and STI transmission
strategies. Resources must be made available to educate adults in the community and teach them
how to talk to young people about sex and reproductive health.
 Input from the majority of parents and guardians should be required to be gathered and
understood before local or state laws are changed regarding the health and well-being of young
people.
Practices
 Students should be directly Involved in decisions that ultimately affect the trajectory of their lives.
This is paramount to achieving youth buy-in, to supporting long-term systemic change, and to
reducing sexual health disparities, particularly among poor youth and youth of color
 A culturally sensitive lens and an intersectional analysis should be applied when creating CSE
curricula to support social outcomes for students. This is a key strategy to addressing health
disparities.
 The input of teachers, particularly those working in high health risk areas, on youth social
development is essential to producing balanced perspectives and outcomes that take into account
the current resources available, and the resources that are needed. Teachers can also provide
essential information about the types of information youth need, and at what age they need it.

CONCLUSION: IT’S TIME FOR CHANGE
23
In their research, Advocates for Youth identified an overarching theme among Millennials of color: they see
using contraception as a responsible choice, and will respond enthusiastically to tools that enable them to
take personal responsibility for their own sexual health, and value on their health, responsibility, and
autonomy.58
Abstinence-only education disadvantages all young people, but it has a disproportionately negative impact
on young people of color, poor youth, young women, and LGBTQIA youth who could benefit most from the
resources that CSE provides. States have a duty to remove discriminatory policies and enact affirmative
measures to improve outcomes for their most vulnerable populations. Policies that do not support
adolescents’ access to CSE perpetuate systemic discrimination and other rights violations of youth, leaving
an indelible mark on the adults they will become. Ultimately, this contributes to the sexual and reproductive
health disparities we see reflected in the statistics in Memphis. Teen pregnancy and STIs carry significant
consequences that can impact one’s whole life. A comprehensive understanding of one’s own sexuality and
reproductive health, on the other hand, is an invaluable tool for navigating relationships and self-care as
teens develop.
In Memphis, community-based organizations like SisterReach and our partners are currently working to fill
in the gaps in the education our children receive. But it is not enough. These organizations cannot reach
every family as their resources are limited. All of Memphis’ young people deserve access to the information
they need to keep themselves safe, to make well-informed decisions, and to have healthy relationships.
As Shelby County Schools continues to redefine and become stronger after the 2013 merger, it is imperative
that the administration consider the needs of the community for CSE. The restrictive opt-in policy should be
repealed and replaced with a policy that goes as far as possible, within the confines of state law, to enable
our youth to access the information and tools they need. Tennessee teens deserve the same level of access to
CSE as other American teens whose states are in compliance with medical expertise. We then call upon
Shelby County teachers, administrators, parents, and students to stand with us in a statewide campaign to
end the restrictions of this harmful curriculum and work to create policies and resources that will ensure
every student in Tennessee has access to evidence-based comprehensive reproductive and sexual health
programs. The need is clear. The time is now.

CITATIONS
24
1 Tennessee Department of Health. Tennessee Adolescent Pregnancy Summary Data, 2010. Rep. N.p.: n.p., n.d. 2012. Web.
29 Oct. 2014. <http://health.state.tn.us/statistics/PdfFiles/AdPreg10.pdf>.
2 National Campaign to Prevent Teen and Unwanted Pregnancy. Fast Facts: Teen Pregnancy in the United States. Rep.
N.p.: n.p., n.d. Aug. 2014. Web. 29 Oct. 2014. <http://thenationalcampaign.org/sites/default/files/resource-primary-
download/fast_facts_-_teen_pregnancy_in_the_united_states_aug_2014.pdf>.
3 "What the Research Says...Comprehensive Sex Education." SIECUS. N.p., Oct. 2009. Web. 27 Oct. 2014.
<http://www.siecus.org/index.cfm?fuseaction=Page.ViewPage&PageID=1193>.
4 Kissi, Samuel K. "Reducing Maternal Mortality through Sexuality Education."#Y4CARMMA. N.p., n.d. Web. 28 Oct. 2014.
<http://www.y4carmma.org/2013/01/reducing-maternal-mortality-through.html>.
5 Braunlin, Sue Ellen. "Promote Sex Education to Reduce Infant Mortality." The Indianapolis Star. N.p., 9 Dec. 2013. Web.
28 Oct. 2014. <http://www.indystar.com/story/opinion/readers/2013/12/09/promote-sex-education-to-reduce-
infant-mortality/3929557/>.
6 Editorial Board. "Editorial: Access to Sex Education and Birth Control Yield 40-year Low in Abortion Rate : News." St.
Louis Post-Dispatch. N.p., 07 Feb. 2014. Web. 28 Oct. 2014. <http://www.stltoday.com/news/opinion/editorial-
access-to-sex-education-and-birth-control-yield-/article_ba446f15-bba3-519b-a190-2d0de5ab8cf7.html>.
7 Kohler, Pamela K., Lisa E. Manhart, and William E. Lafferty. "Abstinence-Only and Comprehensive Sex Education and
the Initiation of Sexual Activity and Teen Pregnancy." Journal of Adolescent Health 42.4 (2008): 344-51. Web.
8 Advocates for Youth. "Comprehensive Sex Education: Research and Results."Advocates for Youth: Publications. N.p.,
Sept. 2009. Web. 26 Oct. 2014. <http://www.advocatesforyouth.org/publications/1487>.
9 Shelby County Health Department Epidemiology Program. HIV Disease and STD Annual Surveillance Summary. Rep.
N.p., n.d. Web. 28 Oct. 2014. <http://shelbycountytn.gov/DocumentCenter/Home/View/17347>.
10 CDC. Reported STDs in the United States: 2012 National Data for Chlamydia, Gonorrhea, and Syphilis. Rep. N.p., n.d.
Web. 28 Oct. 2014. <http://www.cdc.gov/nchhstp/newsroom/docs/std-trends-508.pdf>.
N.p., n.d. Web. 28 Oct. 2014. <http://shelbycountytn.gov/DocumentCenter/Home/View/17347>.
12 CDC. Reported STDs in the United States: 2012 National Data for Chlamydia, Gonorrhea, and Syphilis. Rep. N.p., n.d.
Web. 28 Oct. 2014. <http://www.cdc.gov/nchhstp/newsroom/docs/std-trends-508.pdf>.
N.p., n.d. Web. 28 Oct. 2014.
N.p., n.d. Web. 28 Oct. 2014.
15 "High School YRBS: Memphis, TN 2013 Results." Centers for Disease Control and Prevention. N.p., n.d. Web. 28 Oct.
2014.
<http%3A%2F%2Fnccd.cdc.gov%2Fyouthonline%2FApp%2FResults.aspx%3FTT%3DA%26OUT%3D0%26SID%3D
HS%26QID%3DQQ%26LID%3DMEM%26YID%3D2013%26LID2%3D%26YID2%3D%26COL%3DS%26ROW1%3D
%26ROW2%3D%26HT%3DQQ%26LCT%3D%26FS%3D%26FR%3DR1%26FG%3DG1%26FSL%3D%26FRL%3D%
26FGL%3D%26PV%3D%26TST%3DFalse%26C1%3D%26C2%3D%26QP%3DG%26DP%3D1%26VA%3DCI%26CS
%3DY%26SYID%3D%26EYID%3D%26SC%3DDEFAULT%26SO%3DASC>.
16 Tennessee Department of Health. Tennessee Adolescent Pregnancy Summary Data, 2012. Rep. N.p.: n.p., 2014. Web. 28
Oct. 2014. <http://health.state.tn.us/statistics/PdfFiles/AdPreg12.pdf>.
<http://health.state.tn.us/statistics/PdfFiles/VS_Rate_Sheets_2012/Preg15-192012.pdf>.
17 Tennessee Department of Health. Number of Pregnancies with Rates per 1,000 Females Aged 15-19, by Race, for
Counties of Tennessee, Resident Data, 2012. Rep. N.p., n.d. Web. 28 Oct. 2014.
18 Center for Urban Child Policy. The Implications of Teen Parenting in Shelby County, Tennessee. Rep. The Urban Child
Institute, Apr. 2009. Web. 28 Oct. 2014. <http://www.urbanchildinstitute.org/sites/all/files/2009-04-
Teen_Parenting_Brief.pdf>.
19 SIECUS. “What the Research Says…Comprehensive Sex Education.” SIECUS. October 2009. Web. 18 March 2015.
<http://www.siecus.org/index.cfm?fuseaction=Page.ViewPage&PageID=1193>

CITATIONS
25
20 The National Campaign to Prevent Teen and Unplanned Pregnancy. Emerging Answers 2007: Research Findings on
Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases. Rep. N.p., n.d. Web. 28 Oct. 2014.
<https://thenationalcampaign.org/resource/emerging-answers-2007%E2%80%94full-report>.
21 Advocates for Youth. "Comprehensive Sex Education: Research and Results."Advocates for Youth: Publications. N.p.,
Sept. 2009. Web. 26 Oct. 2014. <http://www.advocatesforyouth.org/publications/1487>.
22 Lindberg, Laura Duberstein, and Isaac Maddow-Zimet. "Consequences of Sex Education on Teen and Young Adult
Sexual Behaviors and Outcomes." Journal of Adolescent Health 51.4 (2012): 332-38. Web.
23 Advocates for Youth. "Young People and Dating Violence: Teaching Healthy Relationship Skills to Protect Health and
Well-Being." Advocates for Youth: Publications. N.p., Mar. 2014. Web. 28 Oct. 2014.
<http://www.advocatesforyouth.org/datingviolence>.
24 Mogilevsky, Miri. "How Sex Education Can Combat Sexual Violence." Secular Woman. N.p., 31 Oct. 2013. Web. 28 Oct.
2014. <http%3A%2F%2Fwww.secularwoman.org%2FHow_Sex_Education_Can_Combat_Sexual_Violence>.
25 Slater, Hannah. "LGBTQIA-Inclusive Sex Education Means Healthier Youth and Safer Schools." Center for American
Progress. N.p., 21 June 2013. Web. 28 Oct. 2014.
<http://www.americanprogress.org/issues/LGBTQIA/news/2013/06/21/67411/LGBTQIA-inclusive-sex-education-
means-healthier-youth-and-safer-schools/>.
26 Georgia Parents for Responsible Health Education. "Who Supports Comprehensive Sex Education?" N.p., 7 Sept. 2009.
Web. 28 Oct. 2014. <http://www.gprhe.org/comprehensive-sex-education/who-supports-comprehensive-sex/>.
27 Collins, Chris, MPP, Priya Aligari, JD, and Todd Summers. Abstinence Only Vs. Comprehensive Sex Education. Rep. San
Francisco: AIDS Research Institute, U of California San Francisco, 2002. Print. Policy Monograph Series.
28 SIECUS. "What the Research Says...Abstinence-Only Sex Education." SIECUS Fact Sheet. N.p., Oct. 2009. Web. 27 Oct.
2014. <http://www.siecus.org/index.cfm?fuseaction=Page.ViewPage&PageID=1195>.
29"International Covenant on Civil and Political Rights." United Nations Treaty Collection. N.p., n.d. Web. 28 Oct. 2014.
<https%3A%2F%2Ftreaties.un.org%2FPages%2FViewDetails.aspx%3Fsrc%3DTREATY%26mtdsg_no%3DIV-
4%26chapter%3D4%26lang%3Den>.
30 "International Convention on the Elimination of All Forms of Racial Discrimination." United Nations Treaty Collection.
N.p., n.d. Web. 28 Oct. 2014. <https://treaties.un.org/Pages/ViewDetails.aspx?src=TREATY&mtdsg_no=IV-
2&chapter=4&lang=en>.
31 UNFPA. "Master Plans for Development." Summary of the ICPD Programme of Action. N.p., n.d. Web. 29 Oct. 2014.
<http://www.unfpa.org/public/cache/offonce/home/sitemap/icpd/International-Conference-on-Population-and-
Development/ICPD-Summary%3Bjsessionid%3D601A58E091A75BA2A74F1ADBD79C0589.jahia01>.
32 World Health Organization. "Defining Sexual Health." Sexual and Reproductive Health. N.p., n.d. Web. 28 Oct. 2014.
<http://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/>.
33 World Health Organization. Defining Sexual Health: Report of a Technical Consultation on Sexual Health. Rep. Geneva:
n.p., 2002. Web. 29 Oct. 2014.
<http://www.who.int/reproductivehealth/topics/gender_rights/defining_sexual_health.pdf?ua=1>.
34 Concluding Observation of the Committee on the Elimination of Racial Discrimination. Rep. N.p.: n.p., n.d.
CERD/C/USA/CO/6, Para 33. Feb. 2008. Web.
<http://www1.umn.edu/humanrts/CERDConcludingComments2008.pdf>.
35 See also, Mauritius, para. 55(b), U.N. Doc. CRC/C/MUS/CO/2 (2006) (“Incorporate reproductive health education in
the school curriculum”); Nepal, para 64(c), U.N. Doc. CRC/C/15/Add/261 (2005) (“Take measures to incorporate
reproductive health education in the school curriculum and conduct awareness-raising campaigns to fully inform
adolescents of reproductive health rights, including prevention of sexually transmitted diseases including HIV/AIDS
and early pregnancies); New Zealand, para. 38(b), U.N. Doc. CRC/C/15/Add. 216 (2003) (“Undertake effective
measures to reduce the rate of teenage pregnancies through, inter alia, making health education, including sex
education, part of the school curriculum, and strengthening the campaign of information on the use of
contraceptives”); Committee on the Elimination of All forms of Discrimination against Women (CEDAW), General
Recommendation No. 24: Article 12 of the Convention (Women and Health), A/54/38/Rev.1, para (1999) (recognizing
that article 10 of the same Convention requires states to ensure women “equal access to education… to redu[ce]
female student drop-out rates, which are often a result of premature pregnancy” and to provide women education
information “to help ensure the health and well-being of families, including information and advice on family
planning.”).

CITATIONS
26
36 Munoz, Vernor, Special Rapporteur on the Right to Education. Report of the United National Special Rapporteur on the
Right to Education,. Rep. N.p.: n.p., 2010. Para. 32, A/65/162. Web. <http://daccess-dds-
ny.un.org/doc/UNDOC/GEN/G11/129/40/PDF/G1112940.pdf?OpenElement>. [hereinafter SR on Right to
Education].
37 Woebse, Erica. "Eating Hot Peppers to Avoid HIV/AIDS: New Challenges to Failing Abstinence-Only
Programs." William & Mary Journal of Women and the Law 20.3 (2014): 708-29. Web.
38 Gay, Lesbian, and Straight Education Network. School Climate in Tennessee: 2011 State Snapshot. Rep. N.p., 2011. Web.
29 Oct. 2014. <http://glsen.org/sites/default/files/Tennessee%20NSCS%20Snapshot%202011.pdf>.
39 "Preventing Sexual Risk Behaviors among Gay, Lesbian, and Bisexual Adolescents: The Benefits of Gay-sensitive HIV
Instruction in Schools."American Journal of Public Health 91.6 (2001): 940-46. Web.
40 SIECUS. Tennessee Legislature Approves Bill Banning “Gateway Sexual Activity”. Rep. N.p., n.d. Web. 29 Oct. 2014.
<http://www.siecus.org/index.cfm?fuseaction=Feature.showFeature&featureID=2170>.
41 “‘Local education agency’ or ‘LEA’ means any county, city, or special school district, unified school district, school
district of any metropolitan form of government or any other school system established by law.” Tenn. Code Ann. §
49-3-302 (11) (West 2014).
42 Tenn. Code Ann. § § 49-6-1302 (a)(1).
43 Tenn. Code Ann § 49-6-1303.
44 Tenn. Code Ann. § 49-6-1301 (7).
45 Tenn. Code Ann. § 49-6-1304.
46 Tenn. Code Ann. § 49-6-1305 (b)
47 Tenn. Code Ann. § 49-6-1306 (a)
48 Id. at (b).
49 Id. at (b).
50 Blumenthal-Barby, J. S., and Hadley Burroughs. "Seeking Better Health Care Outcomes: The Ethics of Using the
“Nudge”." The American Journal of Bioethics 12.2 (2012): 1-10. Web.
51 "Tennessee Sex Ed Bans Mention of "Gateway Sexual Behavior" - Politics News - ABC News Radio." ABC News Radio.
N.p., 2012. Web. 29 Oct. 2014. <http://abcnewsradioonline.com/politics-news/tennessee-sex-ed-bans-mention-of-
gateway-sexual-behavior.html>.
N.p., n.d. Web. 28 Oct. 2014.
53 Participants located in non-high risk zip codes met the ethnicity eligibility criteria
54 Tennessee Department of Health. Tennessee Adolescent Pregnancy Summary Data, 2012. Rep. N.p.: n.p., 2014. Web. 28
Oct. 2014. <http://health.state.tn.us/statistics/PdfFiles/AdPreg12.pdf>.
N.p., n.d. Web. 28 Oct. 2014.
56 Arbour, M., Corwin, E. J. and Salsberry, P. (2009), Douching Patterns in Women Related to Socioeconomic and
Racial/Ethnic Characteristics. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38: 577–585.
doi: 10.1111/j.1552-6909.2009.01053.x
57 Taack Lanier, Judith. Redefining the Role of the Teacher: It’s a Multifacted Profession. Edutopia. 7 July 1997.
<http://www.edutopia.org/redefining-role-teacher>
58 Advocates for Youth. "Contraception" and “Sex Education.” Millennials: Diverse, Connected, and Committed to Sexual
Health and Rights. N.p., n.d. Web. 29 Oct. 2014. <http://www.advocatesforyouth.org/millennials>.

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